Missing Half of the Science: Research Gap in Women’s Health
- Kader Gül Odabaş
- Oct 12
- 6 min read
You’re exaggerating, you’re emotional, you’re being dramatic, you’re sassy, YOU’RE A WOMAN…
Just Too Sensitive (!)
The medical conditions that women experience in their body are often counted as inefficacious on scientific and social basis, most of the time trivialized or evaluated by being reduced to psychological factors only. This leads to systematical ignorance of the problems related to women’s health and unserious approaches in biomedical researches.
The Egyptians associated behavioral disorders with uterus in 1900 BC. That’s why many problems observed in women were passed over with the word “hysteria”, which derived from “hustera” in ancient Greek, meaning “uterus”. Today, it is still included in the literature as a psychoneurotic disorder characterized by psychosomatic complaints and is largely used for women.
It’s an important problem on scientific and social basis that women’s medical concerns are systematically being belittled either in psychological or biological sense. Excluding women intentionally from clinical researches and false diagnosis’ that identify women’s emotional and physiological experiences in a reductionist manner are primary examples for that. It has become a common attitude in modern society for the problems related to women’s health not being taken notice of properly or being ignored constantly. As a direct consequence of this matter, a lot of women face serious uncertainties during diagnosis and treatment process.
Endometriosis: Normalized Pain
Endometriosis is an inflammatory disease that affects 1 in 10 women in their reproproductive age and is caused by the growth of uterine tissue outside the uterus. Endometriosis, which was identified 160 years ago, still has a lot of insufficient information including the definition of the disease itself. It was not researched enough and long been ignored by being reduced to “exeaggerated mensturation pain” even though it was named many years ago.
Lack of knowledge, compounded by carelessness, extends the time to diagnosis for most women to 7 to 10 years. Chronic pain, infertility (50% of patients), depression, fatigue, dizziness, nausea... Despite its challenging symptoms and prevalence, funding for endometriosis research is minimal. Funding for Crohn's disease (chronic inflammatory bowel disease) is 65 times higher per patient than for endometriosis. This demonstrates that endometriosis is severely underfunded. Patients are offered painkillers and controversial surgical procedures as treatment options. Endometriosis recurrence after surgical treatment can vary depending on the surgical technique used, whether the lesions were completely removed, and whether hormonal therapy was used afterward. However, according to data reported in various studies, symptoms or lesions reappear within 5 years in approximately 40–50% of patients.
There is a fact that scientists have known for years: the hormonal cycles (“estrus cycle”) of female animals and women can lead to different results in research. Due to hormonal fluctuations and genetic characteristics, the responses to treatments applied may vary. In other words, it is not surprising that a treatment has different effects in women and men.
But here is the bitter part: this obvious fact is often ignored. Male subjects are preferred in research. Why?
Cost: Tracking the hormonal cycles of female animals takes time.
Convenience: Managing the possibility of pregnancy is difficult.
Profit: For large institutions, it is considered more profitable for female animals to give birth rather than being included in experiments.
The use of female test animals requires monitoring their hormonal cycles and controlling the possibility of pregnancy. This makes the research both longer and more expensive. For large institutions, allowing female animals to give birth instead of including them in experiments is considered more “profitable.” In other words, economic concerns come before scientific integrity. The result? Large gaps arise in understanding the origins and treatments of diseases for women, who make up half of the population.
A similar situation exists in human studies as well. Women who have the possibility of pregnancy are often considered risky for clinical drug trials. Due to the concern of “What if the drug harms the baby?”, women can be excluded from the initial stages of studies. Yes, this concern is understandable, but it also causes women to be excluded from treatment options. Thus, the excuse of “protecting women” turns into blindness that actually puts their health at risk.
On paper, there are some regulations. For example, institutions like the NIH (National Institutes of Health) in the United States require that the sex factor be taken into account in research. However, when it comes to publications, most studies do not follow this rule. Sex analysis is either not performed at all or not included in the results. Thus, the results obtained from male subjects, who are accepted as the “standard human,” are generalized to women as well.
Yet biology tells us very clearly:
Women’s immune systems work differently from men’s.
Hormone levels differ between sexes throughout life.
Even at the chromosomal level, there are functional differences between the sexes.
Despite this, although heart diseases, kidney disorders, and many immunological diseases are more common in women, men are given priority in research. In other words, even in diseases that affect women more, data from women are limited. Sometimes, the situation can be even worse. In some publications:
The sex of the subjects is not indicated at all,
Only one sex is used,
Or data from both sexes are collected but combined and presented as if from a single group.
This leads to both information loss and misleading findings. When data are not analyzed properly, science draws a picture that ignores the biological realities of women.
The systematic exclusion of women from clinical research actually dates back decades. In 1977, the FDA in the United States banned women of childbearing age from clinical trials. The reason was clear: the possibility of pregnancy and potential risks. This ban was lifted in the 1990s, but its effects still continue. Even today, the use of drugs during pregnancy remains one of the least understood subjects. There is a critical gap in terms of women’s and infant health.
When we look at research funding, the picture becomes even more concerning. Diseases specific to women or those more common in women receive far less support compared to male diseases of similar prevalence. As a result, the resources allocated to women’s health do not reflect the real needs of society.
Drugs such as aspirin, sleeping pills, and antidepressants were later found to have more severe side effects in women.
Between 1997 and 2000, 80% of drugs withdrawn from the U.S. market were pulled because of serious side effects observed in women.
In other words, the exclusion of women from research is not just a theoretical “inequality”; it is a deficiency that directly threatens women’s health and can cost lives.
Sometimes it sounds like a joke, but it’s real: women, who make up half of society, have different molecular and physiological characteristics from men — yet the treatment methods developed are studied by ignoring female physiology.
Women’s health is not just an issue for women. This is a problem that casts a shadow over the neutrality of science and undermines social equality. To break the chain of invisibility, fairer funding, gender-based research, and fundamental changes in health policies are necessary.
We must keep the social, economic, psychological, and medical problems faced by women on the agenda not only on March 8, but throughout the year. Because this issue is too critical to be limited to a single day.
References and Suggested Readings
Ellis, K., Munro, D., & Clarke, J. (2022). Endometriosis is undervalued: a call to action. Frontiers in global women's health, 3, 902371.
Guo S. W. (2009). Recurrence of endometriosis and its control. Human reproduction update, 15(4), 441–461. https://doi.org/10.1093/humupd/dmp007
Justice, M. J. (2024). Sex matters in preclinical research. Disease Models & Mechanisms, 17(3), dmm050759.
Kronzer, V. L., Bridges, S. L., Jr, & Davis, J. M., 3rd (2020). Why women have more autoimmune diseases than men: An evolutionary perspective. Evolutionary applications, 14(3), 629–633. https://doi.org/10.1111/eva.13167
Miller, L. R., Marks, C., Becker, J. B., Hurn, P. D., Chen, W. J., Woodruff, T., ... & Clayton, J. A. (2016). Considering sex as a biological variable in preclinical research. The FASEB Journal, 31(1), 29.
Villavisanis, D.F., Schrode, K.M. & Lauer, A.M. Sex bias in basic and preclinical age-related hearing loss research. Biol Sex Differ 9, 23 (2018). https://doi.org/10.1186/s13293-018-0185-7
Wheeler, J. M., & Malinak, L. R. (1983). Recurrent endometriosis: incidence, management, and prognosis. American journal of obstetrics and gynecology, 146(3), 247–253. https://doi.org/10.1016/0002-9378(83)90744-5
Wheeler, J. M., & Malinak, L. R. (1983). Recurrent endometriosis: incidence, management, and prognosis. American journal of obstetrics and gynecology, 146(3), 247-253.
Zakiniaeiz, Y., Cosgrove, K. P., Potenza, M. N., & Mazure, C. M. (2016). Balance of the Sexes: Addressing Sex Differences in Preclinical Research. The Yale journal of biology and medicine, 89(2), 255–259.
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